¹⁸F-Fluoroethyl-l-Thyrosine Positron Emission Tomography to Delineate Tumor Residuals After Glioblastoma Resection: A Comparison with Standard Postoperative Magnetic Resonance Imaging

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• 作者：Niels Buchmann¹ ; ^{niels.buchmann@tum.de" class="auth_mail" title="E-mail the corresponding author} ; Benjamin Kl&auml ; sner² ; ⁶ ; Jens Gempt¹ ; Jan Stefan Bauer³ ; Thomas Pyka² ; Claire Delbridge⁴ ; Bernhard Meyer¹ ; Bernd Joachim Krause² ; ⁵ ; Florian Ringel¹
• 关键词：Control of resection ; FET-PET ; Glioblastoma ; Positron emission tomography ; Recurrence ; Surgery
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：89
• 期：Complete
• 页码：420-426
• 全文大小：1166 K

文摘

Complete resection of contrast-enhancing tumor is an important prognostic factor in glioblastoma therapy. The current clinical standard for control of resection is magnetic resonance imaging (MRI). ¹⁸F-Fluoroethyl-<span class="smallcaps">lspan>-thyrosine (FET) is a positron emission tomography (PET) radiopharmaceutical applicable for widespread use because of its long half-life radionuclide. We assessed the sensitivity of postoperative MRI versus FET-PET to detect residual tumor and the impact of the time interval between resection and FET-PET.

Methods

spara0015">MRI and FET-PET were performed preoperatively and postoperatively in 62 patients undergoing 63 operations. FET-PET was performed in 43 cases within 72 hours after resection and in 20 cases >72 hours after resection. Detection and measurement of volume of residual tumors were compared. Correlations between residual tumor detection and timing of PET after resection and recurrence were examined.

Results

spara0020">Complete resection was confirmed by both imaging modalities in 44% of cases, and residual tumor was detected consistently in 37% of cases. FET-PET detected residual tumor in 14% of cases in which MRI showed no residual tumor. MRI showed residual tumors in 5% of cases that were not identified by PET. Average PET-based residual tumor volume was higher than MRI-based volume (3.99 cm³ vs. 1.59 cm³). Detection of and difference in volume of residual tumor were not correlated with timing of PET after resection or recurrence status.

Conclusions

spara0025">Postoperative FET-PET revealed residual tumor with higher sensitivity than MRI and showed larger tumor volumes. In this series, performing PET >72 hours after resection did not influence the results of PET. We recommend FET-PET as a helpful adjunct in addition to MRI for postoperative assessment of residual tumor.